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©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
Evaluating pediatric ureteropelvic junction obstruction: Dynamic magnetic resonance urography vs renal scintigraphy 99m-technetium mercaptoacetyltriglycine
Yousuf Al-Shaqsi, Matthieu Peycelon, Annabel Paye-Jaouen, Elisabeth Carricaburu, Anca Tanase, Christine Grapin-Dagorno, Alaa El-Ghoneimi
Yousuf Al-Shaqsi, Department of Pediatric Surgery, Sultan Qaboos University Hospital, Muscat 123, Oman
Yousuf Al-Shaqsi, Matthieu Peycelon, Annabel Paye-Jaouen, Elisabeth Carricaburu, Christine Grapin-Dagorno, Alaa El-Ghoneimi, Service de Chirurgie Viscérale et Urologie Pédiatrique, Hôpital Universitaire Robert-Debré, Assistance-Publique Hôpitaux de Paris, Paris 75019, France
Yousuf Al-Shaqsi, Matthieu Peycelon, Annabel Paye-Jaouen, Anca Tanase, Alaa El-Ghoneimi, Centre de Références Maladies Rares, Malformations Rares des Voies Urinaires (MARVU), Paris 97019, France
Matthieu Peycelon, Alaa El-Ghoneimi, Faculté de Médecine, Université de Paris, Paris 75006, France
Anca Tanase, Service d’Imagerie Pédiatrique, Hôpital Universitaire Robert-Debré, Assistance-Publique Hôpitaux de Paris, Paris 75019, France
Christine Grapin-Dagorno, Université Paris 13, Sorbonne Paris Cité, Paris 75013, France
Author contributions: Al-Shaqsi Y contributed to writing and editing; Peycelon M contributed to design and editing; Paye-Jaouen A, Carricaburu E, Tanase A, and Grapin-Dagorno C contributed to data collection and analyzing data; El-Ghoneimi A contributed to design and editing.
Institutional review board statement: This retrospective study was conducted in accordance with the ethical principles outlined in the Helsinki Declaration. Due to the nature of the study involving analysis of de-identified data from existing medical records, formal ethical approval from an institutional review board was not sought. However, efforts were made to ensure patient confidentiality and respect for individual privacy throughout the study process.
Informed consent statement: Informed consent was waived for this retrospective study as it involved the analysis of de-identified data obtained from existing medical records. The study was conducted in accordance with ethical principles and guidelines outlined in the Helsinki Declaration.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Yousuf Al-Shaqsi, MD, Doctor, Surgeon, Department of Pediatric Surgery, Sultan Qaboos University Hospital, Alkhoud BO BOX 38, Muscat 123, Oman.
y.alshaqsi@hotmail.com
Received: November 20, 2023
Peer-review started: November 20, 2023
First decision: December 19, 2023
Revised: January 18, 2024
Accepted: March 12, 2024
Article in press: March 12, 2024
Published online: March 28, 2024
Processing time: 127 Days and 0.7 Hours
BACKGROUND
Ureteropelvic junction obstruction (UPJO) is a common congenital urinary tract disorder in children. It can be diagnosed as early as in utero due to the presence of hydronephrosis or later in life due to symptomatic occurrence.
AIM
To evaluate the discrepancy between dynamic contrast-enhanced magnetic resonance urography (dMRU) and scintigraphy 99m-technetium mercaptoacetyltriglycine (MAG-3) for the functional evaluation of UPJO.
METHODS
Between 2016 and 2020, 126 patients with UPJO underwent surgery at Robert Debré Hospital. Of these, 83 received a prenatal diagnosis, and 43 were diagnosed during childhood. Four of the 126 patients underwent surgery based on the clinical situation and postnatal ultrasound findings without undergoing functional imaging evaluation. Split renal function was evaluated preoperatively using scintigraphy MAG-3 (n = 28), dMRU (n = 53), or both (n = 40). In this study, we included patients who underwent surgery for UPJO and scintigraphy MAG-3 + dMRU but excluded those who underwent only scintigraphy MAG-3 or dMRU. The patients were divided into groups A (< 10% discrepancy) and B (> 10% discrepancy). We examined the discrepancy in split renal function between the two modalities and investigated the possible risk factors.
RESULTS
The split renal function between the two kidneys was compared in 40 patients (28 boys and 12 girls) using scintigraphy MAG-3 and dMRU. Differential renal function, as determined using both modalities, showed a difference of < 10% in 31 children and > 10% in 9 children. Calculation of the relative renal function using dMRU revealed an excellent correlation coefficient with renal scintigraphy MAG-3 for both kidneys.
CONCLUSION
Our findings demonstrated that dMRU is equivalent to scintigraphy MAG-3 for evaluating split renal function in patients with UPJO.
Core Tip: This study aimed to evaluate the discrepancy between dynamic contrast-enhanced magnetic resonance urography (MRU) and scintigraphy 99m-technetium mercaptoacetyltriglycine (MAG-3) in the functional evaluation of ureteropelvic junction obstruction (UPJO). The results show that dynamic contrast-enhanced MRU is equivalent to scintigraphy MAG-3 for evaluating split renal function in cases of UPJO in all pediatric age groups. Moreover, it is safe and accurate and does not require ionizing radiation.
